[Early intensification of glucose-lowering therapy: VERIFY lessons and real clinical practice on the example of the Moscow region diabetes register data]
| Autor: | Inna Vladimirovna Misnikova, V. A. Gubkina, Yu. A. Kovaleva |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty endocrine system diseases Combination therapy Endocrinology Diabetes and Metabolism Population Type 2 diabetes Hypoglycemia Moscow Insulin resistance Diabetes mellitus medicine Humans Hypoglycemic Agents Vildagliptin education Aged education.field_of_study business.industry nutritional and metabolic diseases medicine.disease Metformin Glucose Diabetes Mellitus Type 2 business medicine.drug |
| Zdroj: | Problemy endokrinologii. 66(5) |
| ISSN: | 2308-1430 |
| Popis: | BACKGROUND: The prevalence of T2DM is steadily increasing not only among the elderly, but also at a young age. T2DM is preceded by a long period of significant metabolic changes with the development of insulin resistance and в-cell dysfunction. To reduce the prevalence of complications, treatment is needed which affects several pathophysiological mechanisms underlying the disease. Monotherapy with metformin at the onset of T2DM is often insufficient. The VERIFY study demonstrated the advantage of early administration of a combination of vildagliptin and metformin in relation to the glycemic durability compared to the sequential intensification of metformin with vildagliptin in patients with type 2 diabetes.AIMS: To assess the current situation in terms of the incidence of T2DM complications and the structure of the prescribing glucose lowering drugs based on the data from the Diabetes Register (DR) of the Moscow Region. To demonstrate the advantages of early combination therapy in patients with newly diagnosed T2DM using clinical cases.MATERIALS AND METHODS: The data from the DR of the Moscow region, which is part of the National Diabetes Register of the Russian Federation, were used for the analysis. The data of 6,096 patients with T2DM who died in 2019 were evaluated for building the structure of the causes of death of patients with T2DM. The pattern of glucose-lowering therapy was analyzed based on data of 226,327 patients with T2DM (for 2020), as well as separately of 14,379 patients with newly diagnosed T2DM in 2019. Clinical cases are described based on the data of two patients with T2DM, available in the DR database and outpatient records.RESULTS: In patients with young onset T2DM (CONCLUSIONS: A fairly large propotion of patients with T2DM are on monotherapy with glucouse lowering drugs. Early prescription of the combination of metformin plus vildagliptin provides a longer maintenance of glycemic control without increasing the risk of hypoglycemia and weight gain for patients with newly diagnosed T2DM. |
| Databáze: | OpenAIRE |
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